TY - JOUR
T1 - Abdominal organ procurement in the Netherlands – an analysis of quality and clinical impact
AU - de Boer, Jacob D.
AU - Kopp, Wouter H.
AU - Ooms, Kirsten
AU - Haase-Kromwijk, Bernadette J.
AU - Krikke, Christina
AU - de Jonge, Jeroen
AU - van Heurn, L. W.Ernst
AU - Baranski, Andre G.
AU - van der Vliet, J. Adam
AU - Braat, Andries E.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Between March 2012 and August 2013, 591 quality forms were filled out for abdominal organs in the Netherlands. In 133 cases (23%), there was a discrepancy between the evaluation from the procuring and transplanting surgeons. Injuries were seen in 148 (25%) organs of which 12 (2%) led to discarding of the organ: one of 133 (0.8%) livers, five of 38 (13%) pancreata and six of 420 (1.4%) kidneys (P < 0.001). Higher donor BMI was a risk factor for procurement-related injury in all organs (OR: 1.06, P = 0.011) and donor after cardiac death (DCD) donation in liver procurement (OR: 2.31, P = 0.034). DCD donation is also associated with more pancreata being discarded due to injury (OR: 10.333, P = 0.046). A higher procurement volume in a centre was associated with less injury in pancreata (OR = −0.95, P = 0.013) and kidneys (OR = −0.91, P = 0.012). The quality form system efficiently monitors the quality of organ procurement. Although there is a relatively high rate of organ injury, the discard rate is low and it does not significantly affect 1-year graft survival for any organ. We identified higher BMI as a risk factor for injury in abdominal organs and DCD as a risk factor in livers. A higher procurement volume is associated with fewer injuries.
AB - Between March 2012 and August 2013, 591 quality forms were filled out for abdominal organs in the Netherlands. In 133 cases (23%), there was a discrepancy between the evaluation from the procuring and transplanting surgeons. Injuries were seen in 148 (25%) organs of which 12 (2%) led to discarding of the organ: one of 133 (0.8%) livers, five of 38 (13%) pancreata and six of 420 (1.4%) kidneys (P < 0.001). Higher donor BMI was a risk factor for procurement-related injury in all organs (OR: 1.06, P = 0.011) and donor after cardiac death (DCD) donation in liver procurement (OR: 2.31, P = 0.034). DCD donation is also associated with more pancreata being discarded due to injury (OR: 10.333, P = 0.046). A higher procurement volume in a centre was associated with less injury in pancreata (OR = −0.95, P = 0.013) and kidneys (OR = −0.91, P = 0.012). The quality form system efficiently monitors the quality of organ procurement. Although there is a relatively high rate of organ injury, the discard rate is low and it does not significantly affect 1-year graft survival for any organ. We identified higher BMI as a risk factor for injury in abdominal organs and DCD as a risk factor in livers. A higher procurement volume is associated with fewer injuries.
KW - complications
KW - organ donation
KW - organ procurement
KW - quality
UR - http://www.scopus.com/inward/record.url?scp=85012991836&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/tri.12906
DO - https://doi.org/10.1111/tri.12906
M3 - Article
C2 - 27992973
SN - 0934-0874
VL - 30
SP - 288
EP - 294
JO - Transplant international
JF - Transplant international
IS - 3
ER -